Low serum concentrations of moxifloxacin, prothionamide, and cycloserine on sputum conversion in multi-drug resistant TB

Seung Heon Lee, Kyung Ah Seo, Young Min Lee, Hyun Kyung Lee, Je Hyeong Kim, Chol Shin, Jong Ryul Ghim, Jae Gook Shin, Dong Hyun Kim

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Purpose: Low serum concentrations of drugs used to treat multi-drug resistant tuberculosis (MDR-TB) have occasionally been associated with treatment failure. We determined the frequencies of low serum concentrations of anti-MDR-TB drugs, and assessed the effects of these concentrations on 2-month sputum conversion. Materials and Methods: The serum levels of moxifloxacin (MF), prothionamide (PTH), and cycloserine (CS) were determined for 89 serum samples by high-pressure liquid chromatography-tandem mass spectrometry. Results: Low serum concentrations of MF, PTH, and CS below the minimal levels of the normal ranges were 83.3% (20/24), 59.2% (29/49), and 71.2% (47/66), respectively. There were no significant differences between the 2-month sputum conversion group (n=25) and the 2-month sputum non-conversion group (n=4) in median drug concentrations (μg/mL) of MF (1.46 vs. 1.60), PTH (0.91 vs. 0.70), and CS (14.90 vs. 14.90). However, a poor compliance rate was significantly greater in the 2-month sputum non-conversion group (75.0%, 3/4) than in the 2-month sputum conversion group (0%, 0/25) (p=0.001). Conclusion: The frequency of low serum concentrations of anti-MDR-TB drugs was substantial and might not affect the 2-month sputum conversion rate. Larger prospective studies with timely sampling are needed to investigate the role of therapeutic drug monitoring in MDR-TB.

Original languageEnglish
Pages (from-to)961-967
Number of pages7
JournalYonsei Medical Journal
Volume56
Issue number4
DOIs
Publication statusPublished - 2015 Jul 1

Keywords

  • Cycloserine
  • Drug monitoring
  • Moxifloxacin
  • Multidrug resistance
  • Prothionamide
  • Tuberculosis

ASJC Scopus subject areas

  • Medicine(all)

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